Use of assessment for neuropathic pain in MOGAD

Abstract

Background

Myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) is a central inflammatory autoimmune disease primarily characterized by demyelination of the myelin oligodendrocyte glycoprotein and neuronal damage caused by inflammatory cell infiltration. While many studies have reported pain in adult patients with MOGAD, few have reported pain in pediatric patients.

Case report

An 8-year-old girl developed repeated focal to bilateral tonic-clonic seizures preceded by episodes of falling. Based on the seizures, electroencephalographic and brain MRI findings, and positive anti-MOG antibodies in the blood and cerebrospinal fluid, she was diagnosed with unilateral cortical fluid-attenuated inversion recovery (FLAIR)-hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES). Although the contrast-enhanced spinal MRI showed no abnormalities, she exhibited Lhermitte's sign and neuropathic pain, implying myelitis as a complication. Neuropathic pain was retrospectively assessed using two questionnaires (PainDETECT and Short-Form McGill Pain Questionnaire-2).

Conclusions

We report a case of unilateral cortical encephalitis with suspected myelitis on the MOGAD spectrum. For the assessment of neuropathic pain, the modified questionnaires enabled the quantitative and qualitative evaluation of pediatric MOGAD-related pain.